Nudging for Emergency Room Visits

This trial aims to find better ways to reduce unnecessary emergency room visits by offering support to frequent emergency department (ED) users. Participants will receive either a phone call from a healthcare worker (live outreach) or interactive messages from a chatbot (automated interactive messages), both providing guidance on alternative care options outside the ED. The study will compare how these two methods affect future ED visits and whether participants act on the advice given. Individuals with Geisinger Health Plan insurance who have visited the ED at least four times in the past six months are well-suited for this trial. As an unphased trial, this study allows participants to contribute to innovative solutions for reducing ED visits and improving healthcare access.

The trial information does not specify whether you need to stop taking your current medications.

Research has shown that automated interactive messages, like chatbots, are generally safe. In previous studies, these tools reminded patients about appointments or answered questions instantly. No major safety issues were reported. Participants usually find these messages helpful and easy to use.

The study under consideration includes two types of communication: traditional phone calls from health workers and text messages from chatbots. Phone calls are a common and well-understood method in terms of safety. Chatbot messages, while newer, have been tested in other situations. They provide information and support without any known risks.

Researchers are excited about this trial because it explores new ways to guide patients away from unnecessary emergency room visits. Unlike the standard approach that uses live outreach from community health workers or medical assistants, this trial introduces automated SMS chatbot messages. These messages are interactive and accessible, providing guidance on alternative care options outside of the emergency department. This method could offer a more scalable and immediate way to reduce ER visits by engaging patients directly through their smartphones.

Studies have shown that automated interactive messages, like chatbots, can effectively help patients manage their health. In this trial, one group of participants will receive SMS chatbot messages. Research indicates these messages can improve follow-up care after emergency room visits by helping patients remember and attend their appointments. In one study, patients using a text message chatbot reported finding these tools helpful and easy to use. Additionally, automated messages have proven to be a cost-effective way to encourage patients to seek appropriate care outside the emergency room, reducing unnecessary visits. Another group in this trial will receive outreach from a community health worker or community medical assistant, which is the current standard practice.¹²⁶⁷⁸